Digestion

Feb 19, 2014

Does glyphosate cause celiac disease?

February 19, 2014 By toddcaldecott

A recent paper published in Interdisciplinary Toxicology suggests that Monsanto’s glyphosate may be a direct causative factor in the development of celiac disease. In their review, the authors provide evidence that glyphosate provokes celiac disease through a number of mechanisms:

1. Gut bacteria: Celiac patients often exhibit problems with impaired gut ecology, leading to alterations in bowel function that provoke clinical symptoms. In several animal studies, glyphosate has been shown to be directly toxic to probiotic organisms, facilitating the growth of gut pathogens including Clostridium difficile.

2. Inhibition of cytochrome P450 (CYP): Glyphosate has been shown to inhibit CYP enzymes in the liver, which act to detoxify a variety of poisons acquired from our diet and the environment. Inhibition of CYP not only increases susceptibility to toxins, it also impairs the hydroxylation of vitamin D3. A deficiency of vitamin D3 can be found in as much as 60% of the population that live in northern climates such as Canada, linked to metabolic disorders such as heart disease, and autoimmune disease such as multiple sclerosis. At the same time, glyphosate-induced deficiency of CYP enzymes could lead to increases in retinoic acid, a metabolite of vitamin A that quickly becomes toxic, and may contribute to the pathology of celiac disease. Inhibition of the liver and CYP enzymes by glyphosate could also disrupt the transport of sulfate from the gut to the liver and pancreas, resulting in reduced bile acid production, liver damage, pancreatic inflammation, and damage to the intestinal villi.

3. Nutrient deficiencies: Glyphosate may promote a broad range of nutrient deficiencies commonly seen in celiac disease. Glyphosate has been shown to chelate vital minerals in the GI tract, including iron, molybdenum, and selenium, leading to an increased risk of iron-deficiency anemia, venous thrombosis, and thyroid disorders, all of which are common issues in patients with celiac disease. Other nutrient deficiencies commonly seen in celiac disease also appear to be linked to glyphosate, which disrupts the synthesis of key amino acids in food plants, including tryptophan, tyrosine and methionine, as well as the uptake of iron, magnesium, manganese and calcium.

These are only a few of the points raised by the paper. There is also mention that celiac patients have an increased risk of non-Hodgkin’s lymphoma, the incidence of which has been steadily rising since glyphosate was first introduced in the 1970s. And in a similar fashion, the authors provide a chart showing that the incidence of celiac disease has risen and decreased in direct proportion to glyphosate use, possibly explaining what appears to be the sudden phenomena of widespread gluten intolerance.

So what do I think of the paper? What is immediately striking is that some of the arguments are little more than conjectures, and hence are subject to a great deal of interpretation. It doesn’t help that neither of the authors are medical practitioners nor established experts in the field, and so doubts will be raised about their paper, particularly because the journal that published it, Interdisciplinary Toxicology, isn’t what I would call a mainstream publication. As such, the conclusions of the authors need to be taken with a grain of salt, realizing that the research doesn’t point so much to a smoking gun, as it provides some thought-provoking ideas that needs follow-up from other researchers.

I am no fan of Monsanto, a huge multinational conglomerate that time and again has been found guilty of the agricultural equivalent of piracy. But do I think that Monsanto’s glyphosate is the cause of celiac disease? Perhaps… this review seems rather adamant, and I worry about having too myopic of a focus. We often use terms like “cause” in an exclusive way, not fully comprehending that disease, like life, is multifactoral. Thus while glyphosate could contribute to the incidence of celiac disease and gluten intolerance, there are other explanations as well, apart from the inherent toxicity of this storage protein.

One under-explored mechanism I discuss in Food As Medicine is the inherent toxicity of ALL seeds – essentially – because seeds contain a variety of toxins to discourage predation. Think about it: seeds are little babies, the future of the species, and would any mother send their children off into the world without some kind of protection? Nope – which is why seeds contain a hard waxy coating and are impregnated with a plethora chemicals that are inherently toxic, or do things like inhibit digestion and absorption. There are many many examples of these constituents, including toxic storage proteins, lectins, phytic acid, and non-protein amino acids. Humans are the only mammals to selectively eat and attempt to digest small seeds. To be sure: a cow or a horse may swallow seeds while grazing, but most of the seeds are eliminated undigested in the animal’s stool. This is all part of the dalliance between plants and animals for millions of years, and the plants’ grand design to promote seed distribution.

With the advent of the agricultural revolution 9000 years ago, humans began to selectively eat seeds that we had never eaten before, in large quantities and on a chronic basis. And in so doing, the archeological record shows that our ancestors experienced a dramatic decline in health and longevity, from a life expectancy of around 54 in hunter-gatherers, to around 20 in neolithic farmers. Commensurate with this decrease in longevity was a reduction both body mass and height, as well as an increase in infectious disease, infant mortality, increase in iron deficiency anemia, osteomalacia, dental caries and enamel defects (Cordain 1999).

The basic signs and symptoms of celiac disease have been around for a very long time. In the agrarian society of ancient India, a disease called grahani was described in the texts of Ayurveda, characterized by digestive weakness, chronic diarrhea and weight loss. In ancient Greece, the physician Aretaeus of Cappadocia described a condition called ‘koiliakos’ that resembles celiac disease, bolstered by archeological evidence that celiac disease was found in the Mediterranean (Gasbarrini et al 2012). More recently, a disease called pellagra that has a very similar progression to celiac disease ravaged the south-eastern United states for almost a hundred years, before the cause was determined to be improperly processed corn. Like our experiment with pellagra in the late 19th century, the spectre of widespread gluten intolerance has only arisen since we abandoned traditional methods of food preparation, such as the fermentation of wheat. Similar to the nixtamalization of corn, which prevents pellagra, fermenting wheat not only hydrolyzes gluten into harmless amino acids, but along with cooking, helps to denature the many anti-nutrient factors that have interfere with digestion and absorption. Traditional methods of food preparation such as fermentation have demonstrated their merit in clinical research, showing that when wheat is properly fermented, it can be safely given to celiacs without causing any clinical symptoms (Di Cagno et al 2004). I believe that once we restore these traditional methods of food processing, the incidence of gluten intolerance that has steadily increased over these last few generations will begin to decline. However, as this paper illustrates, there may be other factors in celiac disease, and if the suggestions of the authors prove true, it should be even more incentive to governments to ban the use of glyphosate.

References
Cordain L. 1999. Cereal grains: humanity’s double-edged sword. World Rev Nutr Diet. 84:19-73.
Di Cagno R. et al. 2004. Sourdough bread made from wheat and nontoxic flours and started with selected lactobacilli is tolerated in celiac sprue patients. Appl Environ Microbiol. 70(2):1088-96.
Gasbarrini G et al. 2012. Origin of celiac disease: how old are predisposing haplotypes? World J Gastroenterol. 18(37):5300-4.

Filed Under: Digestion, fermented, Gluten intolerance, glyphosate

Jan 27, 2014

Original “fire cider” for nausea

January 27, 2014 By toddcaldecott

A few weeks ago I had a visit from a family who brought their senior-aged mother to see me, complaining of a relentless nausea. No cause could be ascertained, and she had already spent a couple days in the hospital on IV, but with no respite. When I examined her, the poor lady was very pale and cold, barely coherent, and was listing in her chair, almost falling over. Her family was obviously very worried, but I was confident that I could restore her rather quickly, my optimism based on a little remedy I discovered about 15 years ago. While she and her family waited, I excused myself and made some up. I measured out a dose and diluted it in warm water, gave it to the mother, and then continued talking to the family about ways they could restore her electrolytes and digestion. Within a minute or so, the mother’s pallor changed notably, and she began to sit upright, and answer questions easily. Her eyes were clearer and brighter, and by the time she left a few minutes later, she easily walked out the door on the arm of her daughter.

I knew this remedy would likely benefit her because I have had occasion to test it many times. The first time I found this remedy was when I was searching for something I could give a young female patient that had suffered from intractable nausea for an entire year, as a complication of appendix surgery. She literally could not get out of bed, and had not attended school in the last nine months. Her mother was at her wit’s end, and told me she had tried everything: pharmaceuticals, herbal remedies, homeopathics and acupuncture – nothing had worked so far.

During this period I was also clinical director at a herbal college, and was teaching a course on Physiomedicalism, an early evolute of Western herbal medicine in North America. It was a practice derived from the techniques of a folk herbalist named Samuel Thomson, who is notable not only as the first multi-level marketer in North America, but because he introduced several herbs into the materia medica, including lobelia (Lobelia inflata) and cayenne (Capsicum spp.). For Thomson, cayenne in particular was a herb that was unmatched when it came to holding the “heat” of the stomach, synonymous with good appetite and digestion. In Ayurveda, the stomach is the primary site of kapha, or ‘phlgem’, and when the cold, heavy and congesting qualities of kapha increase, there is a commensurate decline in appetite and digestion. Think of trying to burn wet leaves: instead of heat (digestion), all we get is smoke (nausea). Thus nausea is essentially a disease of kapha, and the primary method for resolving this is to burn away the mucus and congestion by activating the digestive fire. In this way, cayenne can be used for any type of kapha issue, including viral rhinitis and influenza, where the symptoms are characterized by nausea, coldness and mucus congestion. For active fever, however, this is remedy is too heating and should be avoided in favour of gentle diaphoretics such as yarrow, catnip, or elder flower tea.

While cayenne was Thomson’s standby for digestion, I explored further and came across a specific formula in King’s American Dispensatory called “Anti-emetic drops“, comprised of apple cider vinegar, cayenne, salt and water. I decided to try it out and mixed up a batch. I gave it to this young woman and her mother, and within a day I got a report back that the nausea was gone. Cautiously optimistic, I suggested she continue, and let me know how she was doing in a few days. A week later I heard from her mother that she was back at school, hanging out with her friends, now living the life she missed out on for the last year. Although I never saw them again, I received a letter from her mother several years later, telling me that her daughter had finished university – something she said wouldn’t have been possible without my help, and of course, the help of this very useful remedy.

Here is the recipe for King’s Anti-emetic Drops (approximated, using kitchen measurements):

1/2 ounce (15 g) of powdered cayenne
1/4 tsp (2 g) of salt
1 cup (250 mL) apple cider vinegar
1 cup (250 mL) water

Dose: One tablespoon, given as often as required.

The original fire cider?

Lately there has been a bit of a furor over a company that has trademarked the name “fire cider”, which is a combination of vinegar, habanero peppers, and other herbs. Perhaps because I live in Canada, I had never heard of the term “fire cider”, although I am obviously familiar with the ingredients. It seems that some folks are irritated that the company has taken a folk remedy and claimed it as their own. As we can see, the basic formula goes back more than a century, mentioned in the 1898 edition of King’s American Dispensatory, so it is hardly unique. Patents are used to protect inventions, whereas trademarks are used to protect marketing terms, such as product names. And unlike patents, which are supposedly novel inventions, it doesn’t matter how stupid an idea is to get a trademark to protect it. You just need to be first.

While the trademark application itself seems weak and could be challenged, it’s important to point out that there is no limitation on anyone making “fire cider” and calling it such, just as long as they don’t also sell it as “fire cider”. However, I can’t see how this little company is going to be hiring big city lawyers to put small time herbalists out of business at their local farmer’s market. Particularly if everyone does it: bring on World Wide Fire Cider Making Day!

Anyway, in the context of our free market, capitalist economy, it’s hard to fault the company: this is the way the system works, for better or for ill. It was probably a bad business decision on their part not to pick a unique name. Fortunately, herbalists are generally not proprietary folk, so regardless of the name, this and similar remedies should continue to remain part of the commons for a long time to come.

Filed Under: apple cider vinegar, Ayurveda, cayenne, Digestion, fire cider, Kapha, Recipes

Oct 8, 2013

The FODMAPS diet

October 8, 2013 By toddcaldecott

Over the past couple years I have heard practitioners and patients refer to the FODMAP diet as a way to resolve chronic gut issues like irritable bowel syndrome (IBS). In a nut shell, the FODMAP diet refers to the reduction or elimination of foods that contain various long-chain sugars found in foods such as cereals, pulses, root vegetables, and fruits (see this list). Specifically, the term FODMAP is an acronym devised by researchers at Monash University in Australia, referring to foods that contain “Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides and Polyols”. According to proponents of the FODMAP restriction diet, as well as similar diets such as the Specific Carbohydrate and GAPS diet, many of these sugars aren’t properly digested. As a result, they are utilized instead by some of the bacteria that naturally inhabit our intestines, leading to their enhanced growth and fermentation, causing symptoms such as gas, bloating, colic, and diarrhea. Many people following a FODMAP or Specific Carbohydrate diet do indeed find that their symptoms diminish after some time. The problem, however, is that patients quickly find that the diversity and variety of foods in their diet begins to decline dramatically. With these and other restrictions, some may feel that they have painted themselves into a corner, finding that their intolerances and sensitivities actually worsen over time, or that they experience difficult problems such as chronic constipation.

The notion that indigestible sugars can cause gas and bloating isn’t anything new. More than 20 years ago when I began my training as a herbalist, I was taught that a whole foods vegetarian diet was a healthier option than a meat-based diet, and during the first couple years of my practice I encouraged many to make this switch. One of the more common issues I observed, however, was that with the displacement of meat for vegetarian sources of protein such as beans, nuts and seeds, as well as whole grains and root vegetables, patients very often presented with an increase in gas and bloating, and sometimes even experienced diarrhea. I learned to anticipate this, and explain that it was a natural result of adding more high-fiber foods to the diet, which in turn, altered the composition of the microflora in the gut. In many cases, the symptoms of gas and bloating that accompanied these changes were temporary, and usually the symptoms would begin to diminish within a few weeks. Often I would discuss ways to improve digestibility, such proper cooking techniques, and the use of culinary herbs, such as cooking legumes with ginger and garlic. In some patients however, their digestive symptoms didn’t get better, and it was this as well as other reasons, that I soon abandoned the idea that a vegetarian diet was necessarily good or well-suited to everybody. Nonetheless, I learned a great deal about how to deal with digestive issues attributable to a high fibre diet.

It is very clear that some people do note an improvement in their digestive symptoms when they avoid FODMAP-containing foods. But before we celebrate the success of this intervention, it is important to look at some potential problems. Firstly, the FODMAP diet seeks to remove many of the high fibre foods that researchers have linked to a reduction in the risk of hypertension, stroke, elevated LDL cholesterol, ischemic heart disease, diabetes, and colorectal cancer. Some of the FODMAPs have also been shown to benefit chronic digestive disorders such as GERD, ulcer, and hemorrhoid, as well as promote mineral absorption, modulate immune function, resist infection, enhance mood and memory, and promote healthy aging. In this context, the fermentable, indigestible fibres described by the FODMAP system are also called ‘prebiotics’, meaning that they provide a substrate for the growth and development of probiotic bacteria such as Lactobacillus spp., Bifidobacterium spp. and Saccharomyces boulardii. It is well-established that these and related bacterial species promote a healthy gut, which in turn, conveys a benefit to immune and metabolic function. Further, some FODMAP foods such as onion and garlic contain powerful antitumor chemicals such as diallyl disulfide, S-allylcysteine, and ajoene, and when consumed regularly, are highly associated with a significant reduction in cancer risk. Given the weight of evidence in favor of consuming prebiotic foods, is the FODMAP-restricted diet a valid and safe approach for managing chronic digestive disease?

While it may be empirically true that in some cases a FODMAP-restricted diet promotes an improvement of symptoms, we need to ask if the benefits are only attributable to an avoidance of fermentable sugars. Upon review, many of the foods listed by researchers at Monash University as being high in FODMAPs, are also high in a plethora of other molecules that are well-established to cause problems in the gut. In my book Food As Medicine, I review the issue of antinutrient factors (ANFs) in high-fiber foods, which includes constituents such as phytic acid and polyphenols, which chelate minerals and directly inhibit digestive secretions. In the case of cereals and legumes in particular, these foods also contain toxic storage proteins such as gliadin and vicilin that promote inflammation, protease inhibitors that block the function of protein-digesting enzymes, and lectins that can induce gut inflammation and provoke autoimmune diseases. Thus it seems reasonable to challenge the conclusions made by FODMAP proponents that it is just fermentable sugars that are the problem, when in actual fact, the issue is a great deal more complicated. It is also difficult to have a great deal of faith in the FODMAP recommendations, when they state that spelt flour is low FODMAP and gluten-free, when in fact spelt is just a subspecies of wheat (Triticum aestivum subsp. spelta), and most definitely contains gluten. While there is some research showing that fermentation can reduce the gliadin content in sourdough bread, the procedure may require specific strains of bacteria (e.g. Lactobacillus sanfranciscensis) and must be fermented for up to 72 hours at 37°C, and currently, there are a serious dearth of commercial bakeries I know of that ferment their dough long enough to significantly reduce gluten. In other words, if you are following a FODMAP diet but actually have a gluten sensitivity, the recommended FODMAP diet won’t provide any benefit.

As a practitioner that has been studying global food traditions for 20 years, I am not overly impressed by the FODMAP diet and its conclusions. The meal plan is better than the Standard American Diet to be sure, but due to it’s myopic perspective I cannot consider it to be a sustainable diet. To be sure, some people have a very hard time digesting FODMAP foods. But is the solution one of simple avoidance? When we reach back into the history of our culinary traditions, it is very clear that humans have long worked out ways to deal with the digestive issues causes by FODMAPs, as they have been found in our staples for millennia. Beets for example, are a high FODMAP food, with high levels of fructans that can cause gas and bloating. When consumed irregularly, boiled or baked beets are helpful for occasional constipation, and have a laxative activity. When consumed as a staple however, the high levels of indigestible sugars in beets will eventually causes issues, and foment the creation of a gut filled with FODMAP-loving bacteria. Good news for the bacteria, but uncomfortable and bloaty for you.

The solution? Ferment the beets first. Make those same bacteria get the work done for you before you eat it. Surveying the majority of cookbooks, it appears to be a little known fact that a beet “borscht” was originally made with fermented beets – a tradition kept alive by some Jewish families of Ukrainian origin as a dish called russel. Fermentation of the beets beforehand utilizes the same FODMAP-loving bacteria we don’t want to overpopulate our gut with, effectively breaking down indigestible sugars that just cooking cannot. Among poor Jewish farmers during the 20th century Ukraine, beets were very much a staple, but without fermentation it is likely that as a staple it would have resulted in severe malnutrition. Likewise, many different cultures employed fermentation to improve the nutrient bioavailability of their food, including dairy products (e.g. yogurt), cereals (e.g. idli), legumes (e.g. natto), and seeds (e.g. cacao). Perhaps the FODMAP diet should be renamed “The Fermented Food” diet, and then the confusion will cease to persist about which foods can and cannot be eaten. Then we can go back to using prebiotic foods such as garlic and apple, as well as medicinal herbs to modulate the gut, such as Astragalus and Slippery Elm. Generally, all that we need to know about them is that when given in larger doses, prebiotics tend to stimulate a colonic response by encouraging bacterial growth, helping with issues such as constipation. But when there’s gut irritation and diarrhea, indicating bacterial overgrowth, it is wise to use less prebiotics or even eliminate them altogether as a form of population control. It’s that simple. You are in charge of your bacteria by what controlling what you eat.

But what to do with the patient that has removed so many foods from their diet, that they can hardly eat anything at all? Is it a valid therapeutic goal to have someone stuck on a FODMAP diet forever? Or is there something missing? After considering the issue of food preparation, perhaps the answer is found within the process of digestion itself. Ideally, we should all be able to eat a broad variety of properly prepared, whole foods. Dietary ratios will differ for each, based on constitutional or disease factors, and for some there may always need to be a strict avoidance of a particular food – such as gluten. But humans have been consuming high fibre foods and herbs for a very long time, and there is no rational reason why we should not be able to now. Thus a blind adherence to FODMAP, Specific Carbohydrate, and GAPS, as beneficial as they might be to a patient at a certain point in time, misses the mark completely. It’s all about digestion. One major issue that needs to be accounted for, however, is the long term effect of systemic antibiotics on the human microbiome, creating ecological distortions within gut, promoting chronic inflammation and bowel dysfunction. Restoration of a healthy gut ecology is vital, and it could be that for some patients a fecal transplant from a healthy individual is the only answer (although there is some risk of autoimmune reactions). Otherwise, the focus needs to return to digestion, and how to improve it. In future blogs and webinars, I’ll explain this process further.

Filed Under: Diet, Digestion, FODMAPs, Food As Medicine, Gluten intolerance